Influence of occlusal factors on treatment outcome: A study of 109 consecutive patients with mandibular implant-supported fixed prostheses opposing maxillary complete dentures

Purpose: This study was undertaken to investigate the relationship between occlusal variables and clinical and radiologic findings as well as patient response to treatment outcome in patients with mandibular implant-supported fixed prostheses opposing maxillary complete dentures. Materials and Metho ds: The study group consisted of 109 consecutive patients attending for ann ual control. They had received their mandibular implant-supported prosthese s according to the Branemark system on average 8 years previously (range 1 to 27 years). All patients were interviewed with standardized questions by one examiner, who also performed the clinical examination. The questions fo cused on the patients' opinion on masticatory and prosthetic function and p roblems. The clinical examination comprised occlusal and prosthetic factors and the health of the oral mucosa. Results: The great majority of the pati ents were very satisfied with their present dental situation and masticator y function. Two thirds reported no problems with their maxillary complete d entures at all. Balanced occlusion was found bilaterally in 61%, and a furt her 4% had balanced function on one side. More than one third thus lacked b alanced occlusion. Only about 60% had optimal occlusion, and 8% had poor oc clusion according to common prosthodontic criteria. This was interpreted as a continuing impairment of the occlusion with time. The mean bone loss was 0.5 mm, according to available radiographs, for a mean observation period of 54 months. There were no or only weak correlations between the variables examined. Conclusion: The occlusal factors registered were of limited impo rtance for patient satisfaction and treatment outcome recorded clinically a nd radiographically at follow-up examination of the actual prosthodontic re habilitation.